1. Articles from Daniel Chamié

    1-22 of 22
    1. Twelve-month clinical and imaging outcomes of the uncaging DynamX Bioadaptor System

      Aims- We assessed the safety and efficacy of the DynamX™ Novolimus-Eluting Coronary Bioadaptor System, a novel device that initially acts as a second-generation drug-eluting stent, but after six months frees the vessel through uncaging elements. Methods and results- This multi-center study enrolled 50 patients with single de novo lesions. In-device acute lumen gain was 1.61±0.34 mm, and device and procedure success was 100%. Through 12 months, two target lesion failures occurred, both were cardiac deaths (day 255 and 267 post-procedure). No definite or probable device thrombosis was observed. Mean late lumen loss was 0.12±0.18 ...

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    2. Comparison of neointimal coverage between ultrathin biodegradable polymer‐coated sirolimus‐eluting stents and durable polymer‐coated everolimus‐eluting stents: 6 months optical coherence tomography follow‐up from the TAXCO study

      Comparison of neointimal coverage between ultrathin biodegradable polymer‐coated sirolimus‐eluting stents and durable polymer‐coated everolimus‐eluting stents: 6 months optical coherence tomography follow‐up from the TAXCO study

      Aim The TAXCO study was designed to compare the degree of neointimal coverage and the prevalence of malapposition at 6 months subsequent to implantation of ultrathin biodegradable polymer‐coated sirolimus‐eluting stents (SES) and durable polymer‐coated everolimus‐eluting stents (EES) of thin strut thickness using optical coherence tomography (OCT). Methods The TAXCO study included a total of 42 patients who gave consent and underwent OCT examination between August 2017 and September 2017. Of 42, five patients' OCT examinations were of insufficient quality for quantitative analysis. Thus, the OCT analysis group consisted of 37 patients. Among them, 16 patients were ...

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    3. Diagnostic accuracy of 320-row computed tomography for characterizing coronary atherosclerotic plaques: Comparison with intravascular optical coherence tomography

      Diagnostic accuracy of 320-row computed tomography for characterizing coronary atherosclerotic plaques: Comparison with intravascular optical coherence tomography

      Background/Purpose. This study sought to determine the diagnostic accuracy of 320-row computed tomography (320CT) for characterizing coronary atherosclerotic plaques in comparison with optical coherence tomography (OCT). Methods/Materials. From 32 patients, 42 coronary segments were evaluated and co-registered by both 320CT and OCT. 320CT vulnerable plaque characteristics included low attenuation plaque (LAP) (<30HU), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcification (SC). The presence of macrophage, neovascularization and cholesterol crystals was also determined by OCT. Results Minimal lumen area was 2.78 ± 1.23 mm by OCT and 3.29 ± 1.49 mm by 320CT ( p < 0.001 ...

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    4. Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging

      Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging

      Background— To assess the vessel-healing pattern of Ultimaster drug-eluting stent using optical frequency domain imaging. Our hypothesis is that biodegradable polymer-based drug-eluting technology allows complete very early strut coverage. Methods and Results— The DISCOVERY 1TO3 study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months) is a prospective, single-arm, multicenter study. A total of 60 patients with multivessel disease requiring staged procedure at 1 month were treated with Ultimaster. Optical frequency domain imaging was acquired at baseline, 1, 2, and 3 months. The primary end point is optical ...

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    5. Three-dimensional registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      Three-dimensional registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      Evidence suggests high-resolution, high-contrast, 100    frames / s 100  frames/s intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and three-dimensional (3-D) registration methods to provide validation of IVOCT pullback volumes using microscopic, color, and fluorescent cryo-image volumes with optional registered cryo-histology. A specialized registration method matched IVOCT pullback images acquired in the catheter reference frame to a true 3-D cryo-image volume. Briefly, an 11-parameter registration model including a polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition ...

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    6. 3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      High resolution, 100 frames/sec intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and 3D registration methods, to provide validation of IVOCT pullback volumes using microscopic, brightfield and fluorescent cryoimage volumes, with optional, exactly registered cryo-histology. The innovation was a method to match an IVOCT pullback images, acquired in the catheter reference frame, to a true 3D cryo-image volume. Briefly, an 11-parameter, polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition. Virtual catheter parameters were optimized to ...

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    7. Serial Multimodality Imaging and 2-Year Clinical Outcomes of the Novel DESolve Novolimus-Eluting Bioresorbable Coronary Scaffold System for the Treatment of Single De Novo Coronary Lesions

      Serial Multimodality Imaging and 2-Year Clinical Outcomes of the Novel DESolve Novolimus-Eluting Bioresorbable Coronary Scaffold System for the Treatment of Single De Novo Coronary Lesions

      Objectives This study sought to report the late multimodality imaging and clinical outcomes of the novel poly- l -lactic-acid–based DESolve novolimus-eluting bioresorbable coronary scaffold for the treatment of de novo coronary lesions. Background Bioresorbable scaffolds are an alternative to drug-eluting metallic stents and provide temporary vascular scaffolding, which potentially may allow vessel restoration and reduce the risk of future adverse events. Methods Overall, 126 patients were enrolled at 13 international sites between November 2011 and June 2012. The primary endpoint was in-scaffold late lumen loss at 6 months. Major adverse cardiac events, the main safety endpoint, were defined as ...

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    8. Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Objectives This study sought to assess stent-vessel interactions after drug-eluting stent (DES) implantation in unprotected left main coronary artery (ULM) by frequency-domain optical coherence tomography (FD-OCT). Background Percutaneous coronary intervention using DES in ULM has been increasingly performed in routine practice. Recently, FD-OCT assessments of DES-vessel interactions have been used as surrogates for DES safety; however, there are no FD-OCT studies in ULM. Methods We prospectively enrolled 33 consecutive patients with ULM disease treated with sirolimus- (n = 11) and everolimus-eluting stents (n = 22). FD-OCT assessments were performed post-percutaneous coronary intervention and at 9-month follow-up. Three different segments of ULM were ...

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    9. Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Objectives This study sought to investigate the frequency, predictors, and detailed qualitative and quantitative assessment of optical coherence tomography (OCT)-detected stent edge dissections. Its impact on subsequent management and clinical outcomes were also investigated. Background OCT is a high-resolution imaging modality that can lead to more frequent recognition and accurate assessment of vascular injuries during percutaneous coronary intervention (PCI). Methods From September 2010 to June 2011, all patients with OCT post-PCI were enrolled. Edge dissections were defined as disruptions of the arterial lumen surface in both the 5-mm distal and proximal stent edges. Qualitative and quantitative analyses of all ...

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    10. Volumetric Characterization of Human Coronary Calcification by Frequency-Domain Optical Coherence Tomography.

      Volumetric Characterization of Human Coronary Calcification by Frequency-Domain Optical Coherence Tomography.

      Background: Coronary artery calcification (CAC) presents unique challenges for percutaneous coronary intervention. Calcium appears as a signal-poor region with well-defined borders by frequency-domain optical coherence tomography (FD-OCT). The objective of this study was to demonstrate the accuracy of intravascular FD-OCT to determine the distribution of CAC. Methods and Results: Cadaveric coronary arteries were imaged using FD-OCT at 100-μm frame interval. Arteries were subsequently frozen, sectioned and imaged at 20-μm intervals using the Case Cryo-Imaging automated system TM . Full volumetric co-registration between FD-OCT and cryo-imaging was performed. Calcium area, calcium-lumen distance (depth) and calcium angle were traced on every ...

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    11. Very long-term follow-up of strut apposition and tissue coverage with Biolimus A9 stents analyzed by optical coherence tomography

      Very long-term follow-up of strut apposition and tissue coverage with Biolimus A9 stents analyzed by optical coherence tomography

      First generation drug-eluting stents (DES) are associated with reduced in-stent restenosis but significant increased risk of very late stent thrombosis (VLST). The absence of polymer in DES systems may reduce the occurrence of VLST. Optic coherence tomography (OCT) has been used for stent analysis as a surrogate safety endpoint. This study aimed to assess the long-term follow up of strut apposition and tissue coverage of BioMatrix™ DES by OCT. 20 patients undergoing BioMatrix™ DES (n = 15) or S-Stent™ BMS (n = 5) implantation were followed for at least 5 years and evaluated by quantitative coronary angiography, intravascular ultrasound, and OCT. The ...

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    12. Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound

      Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound

      Objectives: To investigate safety and feasibility of imaging unprotected left main (ULM) using frequency-domain optical coherence tomography (FD-OCT) compared with intravascular ultrasound (IVUS). Background: IVUS has been used to assess and guide percutaneous coronary intervention (PCI) of ULM disease. FD-OCT offers 10-fold higher axial resolution than IVUS and its high-speed image acquisition obviates the need for proximal balloon occlusion. Methods: We prospectively enrolled 35 consecutive patients with ULM disease. FD-OCT and IVUS assessments were attempted pre- and post-PCI and compared in regards to safety, ability to image the region of interest (ROI), number of pullbacks, volume of contrast and ability ...

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    13. Feature Of The Week 1/20/13: CWRU Demonstrates Automatic Stent Detection in Intravascular OCT Images Using Bagged Decision Trees

      Feature Of The Week 1/20/13: CWRU Demonstrates Automatic Stent Detection in Intravascular OCT Images Using Bagged Decision Trees

      Cardiovascular disease is the leading cause of death worldwide. Stent implantation by means of percutaneous coronary intervention is the most common coronary revascularization procedure. Intravascular Optical Coherence Tomography (iOCT) is the only imaging modality with the resolution and contrast necessary to enable accurate measurements of luminal architecture and neointima stent coverage. Manual analysis of intravascular OCT pullbacks is time consuming, limiting the size and number of studies that can be performed. We developed a highly automated method for detecting stent struts and measuring tissue coverage. Candidate struts were first identified using image processing techniques. We trained a bagged decision trees ...

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    14. Serial Evaluation of Vascular Response After Implantation of a New Sirolimus-Eluting Stent with Bioabsorbable Polymer (MISTENT): An Optical Coherence Tomography and Histopathological Study

      Serial Evaluation of Vascular Response After Implantation of a New Sirolimus-Eluting Stent with Bioabsorbable Polymer (MISTENT): An Optical Coherence Tomography and Histopathological Study

      Abstract: Background. Novel vascular scaffolds aim at equipoise between safety and efficacy. Intravascular optical coherence tomography (OCT) allows in-vivo serial assessment of stent-vessel interactions with high resolution and frequent sampling and may complement histology assessment. We investigated the vascular response to a novel absorbable coating sirolimus-eluting stent (AC-SES) by means of serial OCT and histology evaluation in a porcine model. Methods. One AC-SES and one bare-metal stent (BMS) were implanted in separate coronary arteries of three Yucatan mini-swine. Serial OCT was performed post procedure and at 3-, 28-, 90-, and 180-day follow-up. Normalized optical density (NOD) was used for the ...

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    15. Automatic stent detection in intravascular OCT images using bagged decision trees

      Automatic stent detection in intravascular OCT images using bagged decision trees

      Intravascular optical coherence tomography (iOCT) is being used to assess viability of new coronary artery stent designs. We developed a highly automated method for detecting stent struts and measuring tissue coverage. We trained a bagged decision trees classifier to classify candidate struts using features extracted from the images. With 12 best features identified by forward selection, recall (precision) were 90%–94% (85%–90%). Including struts deemed insufficiently bright for manual analysis, precision improved to 94%. Strut detection statistics approached variability of manual analysis. Differences between manual and automatic area measurements were 0.12 ± 0.20 mm 2 and 0.11 ...

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    16. Unrestricted utilization of frequency domain optical coherence tomography in coronary interventions

      Unrestricted utilization of frequency domain optical coherence tomography in coronary interventions

      Frequency domain optical coherence tomography (FD-OCT) has shown promise to evaluate coronary devices in clinical trials, however, little is known about its application in clinical practice. This prospective, single center initiative planned for 100 % FD-OCT utilization in all patients undergoing coronary interventions during a 60-day period. Operators pre-specified the planned intervention based on angiography alone. FD-OCT success was defined as acquisition of good quality images enabling adequate quantification of vessel dimensions and lesion/percutaneous coronary intervention (PCI) assessment. Impact on management occurred when angiography-based planning was altered based on FD-OCT data. There were 297 FD-OCT acquisitions performed in 155 vessels ...

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    17. Three-Dimensional Fourier-Domain Optical Coherence Tomography Imaging: Advantages and Future Development

      Three-Dimensional Fourier-Domain Optical Coherence Tomography Imaging: Advantages and Future Development

      Traditionally, intravascular imaging methods display the coronary anatomy in two dimensions, through a series of consecutive cross-sectional tomographic images. The physician is then required to mentally reassemble these images in order to visualize the vascular anatomy and all its complex interactions. The ability to depict the vascular structure with its actual spatial appearance, in three dimensions, is a powerful way to provide an easy, objective, and comprehensive overview of its complex and dynamic anatomy. However, three-dimensional (3D) application of intravascular imaging has been plagued by lack of enough resolution, frequent presence of imaging and motion artifacts and need for extensive ...

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    18. Volumetric quantification of fibrous caps using intravascular optical coherence tomography

      Volumetric quantification of fibrous caps using intravascular optical coherence tomography

      The rupture of thin-cap fibroatheroma accounts for most acute coronary events. Optical Coherence Tomography (OCT) allows quantification of fibrous cap (FC) thickness in vivo. Conventional manual analysis, by visually determining the thinnest part of the FC is subject to inter-observer variability and does not capture the 3-D morphology of the FC. We propose and validate a computer-aided method that allows volumetric analysis of FC. The radial FC boundary is semi-automatically segmented using a dynamic programming algorithm. The thickness at every point of the FC boundary, along with 3-D morphology of the FC, can be quantified. The method was validated against ...

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    19. Congratulations to Zhao Wang from CWRU a Winner of a 2012 Student Travel Grant Award

      Congratulations to Zhao Wang from CWRU a Winner of a 2012 Student Travel Grant Award
      Zhao Wang from Case Western Reserve University is one of four winners of the OCT News 2012 student travel grant awards (see prior announcement Here). Below is a summary of his work.   Coronary artery disease is the leading cause of death worldwide. The rupture of thin-cap fibroatheroma (TCFA) accounts for most acute coronary events. Optical Coherence Tomography (OCT) is able to quantify the fibrous cap (FC) thickness in vivo. Conventional analysis measuring the thinnest part of the FC is subject to inter-observer variability and does not capture the 3-D morphology of the FC. The aim of this study is to ...
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    20. Optical Coherence Tomography and Fibrous Cap Characterization

      Optical Coherence Tomography and Fibrous Cap Characterization
      The pathophysiology of acute coronary syndromes has long been associated with atherosclerotic plaque rupture. Inflammation, thinning, and disruption of the fibrous cap have been implicated with the final processes leading to plaque rupture, but confirmation of these mechanisms of coronary thrombosis in humans has been hampered by the lack of imaging methods with sufficient resolution to resolve fibrous cap characterization and thickness in vivo. Intravascular optical coherence tomography (OCT) provides images with micron-level axial and lateral resolution, enabling detailed visualization of micro-structural changes of the arterial wall. The present article provides an overview of the potential role of OCT in ...
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    21. Utilization of frequency domain optical coherence tomography and fractional flow reserve to assess intermediate coronary artery stenoses: conciliating anatomic and physiologic information

      Utilization of frequency domain optical coherence tomography and fractional flow reserve to assess intermediate coronary artery stenoses: conciliating anatomic and physiologic information

      Fractional flow reserve (FFR) and intravascular imaging respectively provide hemodynamic and anatomical assessments of angiographic intermediate stenoses. Frequency domain optical coherence tomography (FD-OCT) is a promising high-resolution imaging modality, but its clinical use in determining severity of coronary disease has yet to be determined. There, we set out to determine the role of FD-OCT to complement FFR in the evaluation of intermediate coronary artery stenoses. FD-OCT was planned in 176 consecutive interventional procedures at our institution to delineate the proper use of FD-OCT in clinical practice. The decision to use other invasive assessments was at the discretion of the operator ...

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    22. Optical coherence tomography endpoints in stent clinical investigations: strut coverage

      Optical coherence tomography endpoints in stent clinical investigations: strut coverage
      Late stent thrombosis (LST) and very LST (VLST) are infrequent complications after drug-eluting stent (DES) implantation, but they carry a significant risk for patients. Delayed healing, which may be represented by incomplete stent coverage, has been observed in necropsy vessel specimens treated with DES. As a result, in vivo assessment of stent coverage, as well as stent apposition using optical coherence tomography (OCT), have been recently used as surrogate safety endpoints in clinical trials testing DES platforms. By adopting strut coverage assessed by OCT, one can assess the safety profile of the new generation of DES in preregistration studies. This ...
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    1-22 of 22
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    Optical coherence tomography endpoints in stent clinical investigations: strut coverage Utilization of frequency domain optical coherence tomography and fractional flow reserve to assess intermediate coronary artery stenoses: conciliating anatomic and physiologic information Optical Coherence Tomography and Fibrous Cap Characterization Congratulations to Zhao Wang from CWRU a Winner of a 2012 Student Travel Grant Award Volumetric quantification of fibrous caps using intravascular optical coherence tomography Three-Dimensional Fourier-Domain Optical Coherence Tomography Imaging: Advantages and Future Development Automatic stent detection in intravascular OCT images using bagged decision trees Feature Of The Week 1/20/13: CWRU Demonstrates Automatic Stent Detection in Intravascular OCT Images Using Bagged Decision Trees Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography Retinal Vascular Features in Ocular Blunt Trauma by Optical Coherence Tomography Angiography Non-invasive imaging of a choroidal macrovessel